In a 2000 episode of The Simpsons, a flash forward shows Lisa being elected the first heterosexual female U.S. President. Her biggest challenge is fixing the economy: “As you know, we’ve inherited quite a budget crunch from President Trump.” Did this animated show predict the 2016 election?

I am currently reading Chernow’s Hamilton biography, which lends a great deal of insight into the current election. From our Constitutional beginning, there has been a philosophical split in this country between those like Hamilton who viewed a strong federal government and an industrialized nation.…

Every four years the United States chooses a new chief executive. Although encoded in the Constitution, the idea that a person with such power would willingly surrender it and walk away to allow another to lead is remarkable. It was even more remarkable in 1797 when George Washington began this tradition of a peaceful transition of power, an action that was nearly unthinkable in a world ruled by monarchs. As the character of King George says in the musical Hamilton, “I wasn’t aware that was something a person can do.…

More and more frequently, stories are appearing of drug companies buying patents of investment firms buying drug companies and then raising the cost dramatically. First there was Turing Pharmaceuticals that raised the cost of a toxoplasmosis drug by 5500% after the company bought the patent. EpiPen is currently in the news with its leaders having to appear before Congress and explain why it’s price increased 791% after being acquired by Mylan Pharmaceuticals. Now Novum Pharma, after purchasing several drugs from Primus Pharmaceuticals has raised the price of drugs used to treat eczema and skin infections.…

The FDA has announced that within the next 3 months, all donated blood in the United States should be screened for Zika virus. Puerto Rico and Florida are already conducting such screening. In the next four weeks, 11 more states should be screening (Alabama, Arizona, California, Georgia, Hawaii, Louisiana, Mississippi, New Mexico, New York, South Carolina and Texas) followed by nationwide testing within the next 3 months. The goal is to have a safe and trusted blood supply.…

In Illinois, Land of Lincoln insurance and Aetna announced that they are pulling out of the health insurance Marketplace. In other states, United HealthCare and Humana have announced pulling out of the exchanges. As a result, many newspaper headlines and political pundits have declared the Affordable Care Act (ACA, also known as Obamacare) to be in a “death spiral.”

Such statements are undermined by the latest studies showing the ACA is working. The Kaiser Family Foundation reported that three-quarters of people who lacked insurance before the ACA now have it.…

During a periodic training on the university’s harassment policies today, I learned that my institution has added “genetic information” to the list of characteristics against which one cannot be discriminated. When one of my colleagues asked, “Do you have an example of that,” the presenter stumbled. After a few beats she said if someone had a gene for a disease but did not have any symptoms of that yet or an evident physical disability.

Unlike in last month’s GOP debate, in the Democratic Presidential Candidate debate last night, health care issues were not a central factor. If you recall, the GOP debaters went round in circles about whether children should be vaccinated. In the DNC debate, health care issues were raised in a brief mention of Obamacare (i.e. “Affordable Care Act (ACA)) and in greater depth in discussing insurance coverage of undocumented individuals.

Various ethical theories underlie approaches to resolving bioethical dilemmas. Consequentialist theories hold that the moral evaluation of an action is based solely upon the goodness or badness of its consequences for all of the relevant parties. Deontological theories, on the other hand, hold that the moral evaluation of an action is based at least in part upon its intrinsic nature and its resulting conformity to moral rules. Popular deontological theories utilized in bioethics include Kantianism, Natural Rights theory, or theories about Special Obligations (e.g., physician fiduciary duties).…

In this issue of The American Journal of Bioethics (AJOB), Adina Preda and Kristin Voigt (2015) investigate the relationship between health policies, social determinants of health, and health inequalities. There is much empirical work demonstrating the correlation between social determinants of health and health outcomes, which establishes a clear relationship between a person’s social and economic status and her health outcomes. What are defined as social determinants of health varies depending on institution or organization, but the World Health Organization (WHO) broadly explains social determinants of health as “the conditions in which people are born, grow, live, work and age” and further, that “these circumstances are shaped by the distribution of money, power and resources at global, national and local levels” (World Health Organization, Social Determinants of Health.…

How do physicians diagnose disease? First they go through a set of symptoms and then compile a list of differential diagnoses or what the underlying disease may be. Then the doctor performs tests to rule out some diagnoses and advance others. In essence, though, diseases are classified according to their affect on the body—their symptology. What if instead of by symptoms, diseases were classified by their molecular function? Instead of being diagnosed with Type II Diabetes one might be diagnosed by whether there is a death of beta cells (i.e.…

The United States has passed a milestone, the first year of the Affordable Care Act’s insurance mandate. This is the requirement that all U.S. residents have health insurance whether through an employer, an organization, or via the insurance marketplaces. Opponents of the ACA (also known as “Obamacare”) feared that this act would destroy the country by decimating the economy, creating a federal government takeover of healthcare, forcing employers to drop coverage, workers quitting who no longer need their employer-based health insurance, and companies cutting workers to stay below minimum thresholds.…

Say there was a simple change that could be made to the health care system that would reduce cost, reduce demand, increase patient’s quality of life and satisfaction, address the whole patient and not just the disease, improve care coordination, and increase patient autonomy. All of this is possible, but it requires addressing the problem that in America we do not die as we want to.